Provider Demographics
NPI:1134362999
Name:HEFFERNAN, SEAN PHILIP (MD)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:PHILIP
Last Name:HEFFERNAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1800 ORLEANS ST
Mailing Address - Street 2:MEYER 1-104
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0010
Mailing Address - Country:US
Mailing Address - Phone:443-519-6566
Mailing Address - Fax:410-614-5914
Practice Address - Street 1:1800 ORLEANS ST
Practice Address - Street 2:MEYER 1-104
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0010
Practice Address - Country:US
Practice Address - Phone:443-519-6566
Practice Address - Fax:410-614-5914
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2013-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD00753572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry